Capecitabine and sixth cranial nerve palsy

Area of Science:

• Oncology
• Neuroscience
• Pharmacology

Background:

• Capecitabine is an oral chemotherapeutic agent, a prodrug of 5-fluorouracil (5-FU).
• Chemotherapy-induced neurotoxicity can affect both central and peripheral nervous systems.
• Colorectal cancer treatment frequently involves agents like capecitabine.

Observation:

• A 60-year-old male patient with colonic carcinoma developed diplopia.
• The diplopia was diagnosed as a sixth nerve palsy.
• The palsy occurred subsequent to the administration of capecitabine.

Findings:

• Cranial MRI revealed no space-occupying lesion or vascular insult.
• The sixth nerve palsy resolved spontaneously after capecitabine discontinuation.
• This case suggests a potential link between capecitabine and cranial nerve palsies.

Implications:

• Physicians should be vigilant for neurotoxicities associated with capecitabine.
• Understanding capecitabine-induced neurotoxicity is crucial for patient management.
• Further research is warranted to clarify the mechanisms of capecitabine-related neurotoxicity.